Association between diabetic retinopathy and incident cognitive impairment.

Abstract

BACKGROUND/AIM:

The relationship between diabetic retinopathy (DR) and cognitive impairment (CI) is unclear due to equivocal findings from cross-sectional studies and a lack of long-term data. In this population-based cohort study, we investigated the longitudinal association between the severity of DR and the incidence of CI.

METHODS:

682 participants with diabetes, gradable retinal photographs and no CI at baseline 2004-2011) and complete relevant data at follow-up 2010-2016 from the Singapore Epidemiology of Eye Disease Study were included. CI was assessed using the validated Abbreviated Mental Test (AMT), defined as scores of ≤6 and ≤8 for those with 0-6 and >6 years of formal education, respectively. Six-year incident CI was defined as having no CI at baseline but present at the follow-up visit.

RESULTS:

Of the 682 included participants, 483 (70.8%) had no DR and 199 (29.2%) had any DR. Of those with DR, 142 (20.8%) had minimal/mild DR and 57 (8.4%) had moderate or worse DR at baseline. At the follow-up visit, 40 (5.9%) participants had incident CI based on AMT. In multivariate analysis compared with participants without DR, those with any DR had more than twofold increased odds of incident CI (OR (95% CI): 2.32 (1.07 to 5.03)). Participants with moderate or worse DR had threefold increased odds of developing CI (3.41 (1.06 to 11.00)), compared with those with no DR.

CONCLUSIONS:

DR, particularly at the more severe stages, is associated with increased risk of developing CI, independent of vision and other risk factors.

• Authors: Preeti Gupta, Alfred Tau Liang Gan, Ryan Eyn Kidd Man, Eva K Fenwick, Charumathi Sabanayagam, Paul Mitchell, Carol Y Cheung, Ning Cheung, Tien Yin Wong, Ching-Yu Cheng, Ecosse Luc Lamoureux
• Journal: The British journal of ophthalmology (Br J Ophthalmol) Vol. 103 Issue 11 Pg. 1605-1609 (11 2019) ISSN: 1468-2079 [Electronic] England
• PMID: 31645330 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Blood Glucose
• Glycated Hemoglobin A
• hemoglobin A1c protein, human

Topics

• Aged
• Asian People (ethnology)
• Blood Glucose (metabolism)
• Blood Pressure (physiology)
• Cognitive Dysfunction (diagnosis, epidemiology)
• Cohort Studies
• Cross-Sectional Studies
• Diabetes Mellitus, Type 1 (complications)
• Diabetes Mellitus, Type 2 (complications)
• Diabetic Retinopathy (diagnosis, epidemiology)
• Female
• Glycated Hemoglobin (metabolism)
• Humans
• Incidence
• Male
• Middle Aged
• Risk Factors
• Singapore (epidemiology)